颅内外动脉并发狭窄导致的脑梗死模式  

Cerebral infarction patterns induced by intracranial and extracranial artery concurrent stenosis

作　　者：王普清[1] 王安平[1] 曹志华[1] 陈华先[1] 宋金辉[1] 黄栎[1] 周佩洋[1] 王守安[1] 李小龙[1] 

机构地区：[1]湖北医药学院附属襄阳医院神经内科,441000

出　　处：《临床神经病学杂志》2012年第5期331-334,共4页Journal of Clinical Neurology

基　　金：湖北省卫生厅科研基金(JX4B64)

摘　　要：目的探讨颅内外动脉并发狭窄导致的脑梗死的模式。方法用CT血管成像(CTA)检测185例急性脑梗死患者的颅内外动脉的狭窄情况;MR弥散加权成像(DWI)检查确定患者的脑梗死模式:单发或多发性脑梗死,穿动脉梗死(PAI)、皮质支梗死(PI)、分水岭梗死(BZI)、大面积脑梗死。比较并发狭窄与非并发狭窄患者的脑梗死模式。结果 CTA示颅内外动脉并发狭窄69例,其中串联狭窄49例、非串联狭窄20例;非并发狭窄99例;无狭窄17例。颅内外动脉并发狭窄组的多发性脑梗死、PAI+PI+BZI的比率(55.1%,20.3%)显著高于非并发狭窄组(34.3%,5.1%)(均P<0.01);而单发小PAI的比率(24.6%)显著低于非并发狭窄组(48.5%)(P<0.01)。并发狭窄组中串联狭窄亚组的多发性脑梗死(65.3%)及PAI+PI+BZI(26.5%)的比率显著高于非串联狭窄亚组(30%,5%)(P<0.05～0.01);而单发小PAI的比率(14.3%)显著低于非串联狭窄亚组(50.0%)(P<0.01)。结论颅内外动脉并发狭窄导致的脑梗死以多发性梗死及PAI+PI+BZI的模式多见。Objective To explore the cerebral infarction patterns induced by intracranial and extracranial artery concurrent stenosis. Methods The condition of intracranial and extracranial artery concurrent stenosis in 185 patients with acute ischemie stroke were checked by CT angiography （CTA）. MR diffusion-weighted imaging （DWI） were performed to definite infarction patterns. The infarction patterns were classified as： single or muhiple infarct; perforator artery infarct （PAI）, pialartery infarct （PI）, border-zone artery infarct （BZI）, large territorial infarct. The infarction patterns of concurrent stenoses and nonconcurrent stenoses were compared with each other. Results There were 69 patients with concurrent stenoses, including tandem lesions 49 cases and nontandem lesions 20 cases. There were 99 patients with nonconeurrent stenoses and 17 patients without stenoses. The rates of multiple infarction and PAI ＋ PI ＋ BZI in concurrent stenoses group （55. 1%, 20. 3% ） were significantly higher than those in noconcurrent stenoses group（34.3%, 5. 1% ） （all P 〈 0. 01 ）; while the rate of single small PAI （24.6%） in concurrent stenoses group was significantly lower than that in the noeoncurrent stenoses group （48.5 % ） （P 〈 0. 01 ）. The rates of multiple infarction and PAI＋ PI ＋ BZI in the tandem stenoses subgroup of concurrent stenoses group （65.3%, 26.5% ） were significantly higher than those in the nontandem stenoses subgroup （30%, 5% ） （P 〈 0. 05 -0.01 ） ; while the rate of single small PAI （ 14.3% ） in the tandem stenoses subgroup was significantly lower than that in the nontandem stenoses subgroup （ 50. 0% ） （ P 〈 0. 01 ）. Conclusion The patterns of multiple infarction and PAI＋ PI ＋ BZI are more in cerebral infarction patients induced by intracranial and extracranial artery concurrent stenoses.

关 键 词：颅内外动脉 并发狭窄 脑梗死 梗死模式 

分 类 号：R743.3[医药卫生—神经病学与精神病学]